Having chronic pain can also affect relationships, reduce sex drive, and cause low mood and depression. Pain in the genital area is often difficult to talk about with friends and it's not uncommon to feel isolated.

You cannot self-refer to these services, but you could discuss a referral with your GP.

Treatments for vulvodynia

A combination of some of the following treatments can often help relieve symptoms of vulvodynia and reduce its impact on your life.

Self-care

The following lifestyle tips may help reduce symptoms of vulvodynia:

Wear 100% cotton underwear and loose-fitting skirts or trousers.

Avoid scented hygiene products such as feminine wipes, bubble bath and soap – an emollient is a good substitute for soap.

Apply cool gel packs to your vulva to soothe the pain.

Use petroleum jelly before swimming to provide protection from chlorine.

Try not to avoid sex or touching your vulva completely, as this may make your vulva more sensitive – if sex is painful, try to find a position that's more comfortable, or if penetration is painful do other sexually intimate activities together until you've sought advice.

Over-the-counter gels and lubricants

Applying the anaesthetic gel lidocaine to your vulva about 10 minutes before sex may make it more comfortable. To stop the gel getting on your partner, either wipe it off just before having sex or ask your partner to wear a condom (if using condoms, use latex-free ones as latex condoms can be damaged by lidocaine).

If your pain is more constant, applying lidocaine regularly throughout the day may help. Lidocaine can also be used overnight. A tip is to put some on a cotton make-up removal pad and put it onto the sore area so it's held in place by your underwear.

It's very common to have some burning when the lidocaine is initially applied which can last several minutes before going numb. Try to give the lidocaine time it to work, but if the burning continues for 10 minutes, wash it off thoroughly.

Tubes of 5% lidocaine gel, cream or ointment can be bought over the counter from a pharmacy, although it's a good idea to get a doctor's advice before trying it.

Vaginal lubricants and aqueous cream (also available over the counter) may soothe the area and help moisturise the vulva if it's dry. Speak to your pharmacist about these treatments.

Prescription medication

Conventional painkillers such as paracetamol won't usually relieve the pain of vulvodynia. But several medications available on prescription can help, including:

antidepressants called amitriptyline and nortriptyline – possible side effects include drowsiness, weight gain and dry mouth

anti-epilepsy medicines called gabapentin and pregabalin – possible side effects include dizziness, drowsiness and weight gain

Your doctor will probably start you on a low dose and gradually increase it until your pain subsides. You may need to take the medication for several months.

Physiotherapy

A physiotherapist can teach you some pelvic floor exercises (such as squeezing and releasing your pelvic floor muscles) to help relax the muscles around your vagina.

Another technique to relax the muscles in the vagina and desensitise it involves using a set of vaginal trainers. These are smooth cones of gradually increasing size and length which can be inserted into your vagina in the privacy of your own home.

Therapy and counselling

Cognitive behavioural therapy (CBT) is a type of therapy that aims to help you manage your problems by changing how you think and act. It can often help women cope with the impact that vulvodynia has on their life.

CBT focuses on the problems and difficulties you have now, and looks for practical ways you can improve your state of mind on a daily basis.

Psychosexual counselling is helpful when pain is affecting intimacy between you and your partner. This is a type of therapy that aims to address problems such as fear and anxiety about sex, and to restore a physical relationship with your partner.

Surgery

Only in very rare cases, surgery to remove part of the vulva may be an option. Pain however can recur and it's usually not recommended.

Possible causes of vulvodynia

The exact cause of vulvodynia is unknown.

It's thought it may be the result of a problem with the nerves supplying the vulva, although it's not clear what causes this.

Possible triggers that have been suggested include damage due to previous surgery or childbirth, trapped nerves or a history of severe vaginal thrush.

Vulvodynia is not contagious. It has nothing to do with personal hygiene and isn't a sign of cancer.

Other causes of vulval pain

Pain in the vulva isn't always vulvodynia. It can have a number of other causes, such as:

Your doctor may want to rule out these conditions before treating you for vulvodynia. Some women can have a combination of problems, for example recurrent thrush and vulvodynia, with both needing proper treatment to reduce pain.

Support and more information

Living with a long-term painful condition such as vulvodynia can be frustrating and stressful.

You may find it useful to contact a support group for more information and advice or to get in touch with other women who have vulvodynia.